Vaccine decision-making begins in pregnancy: Correlation between vaccine concerns,intentions and maternal vaccination with subsequent childhood vaccine uptake |
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| Institution: | 1. Vaccine and Immunisation Research Group, Murdoch Childrens Research Institute, Australia;2. Department of General Medicine, The Royal Children’s Hospital, Australia;3. School of Population and Global Health, The University of Melbourne, Australia;4. Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Western Australia, Australia;5. Sir Walter Murdoch School of Public Policy and International Affairs, Murdoch University, Australia;6. Sydney School of Public Health, Sydney Medical School, University of Sydney, Australia;7. National Centre for Immunisation Research and Surveillance, Australia;8. The Alfred Hospital, Royal Women’s Hospital and Monash Health and Monash University, Australia;9. Women’s and Children’s Hospital and Robinson Research Institute, The University of Adelaide, South Australia, Australia;10. Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Australia;1. Sanofi Pasteur, 69367 Lyon Cedex 7, France;2. Kingston Business School, Kingston University London, Kingston upon Thames, U.K.;3. BeCHANGE Research Group, Institute of Public Communication, Faculty of Communication Sciences, Università della Svizzera italiana, Lugano, Switzerland and Institute for Global Health Innovation, Faculty of Medicine, Imperial College London, U.K.;1. Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, United States;2. Department of Gynecology and Obstetrics, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Atlanta, GA 30303, United States;3. Emory University School of Medicine, 201 Dowman Dr, Atlanta, GA 30322, United States;1. School of Paediatrics and Child Health, University of Western Australia, Subiaco, WA, Australia;2. Princess Margaret Hospital for Children, Subiaco, WA, Australia;3. Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Subiaco, WA, Australia;4. PathWest Laboratory Medicine WA, Nedlands, WA, Australia;5. Communicable Disease Control Directorate, Department of Health, Perth, WA, Australia;6. Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia;7. Australian National University, Canberra, ACT, Australia;8. School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA, Australia;1. Health Protection Surveillance Centre, Dublin, Ireland;2. European Programme for Intervention Epidemiology Training, Stockholm, Sweden;1. The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia;2. Monash Infectious Diseases, Monash Health, Melbourne, Australia;3. Safer Care Victoria, Victorian Department of Health and Human Services, Melbourne, Australia;4. Infection and Immunity, Monash Children’s Hospital, Melbourne, Australia;5. Monash Centre for Health Research and Implementation, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia;1. Department of Obstetrics and Gynaecology, Faculty of Medicine, National University of Malaysia, Universiti Kebangsaan Malaysia Medical Centre, Malaysia;2. Department of Community Health, Faculty of Medicine, National University of Malaysia, Universiti Kebangsaan Malaysia Medical Centre, Malaysia |
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| Abstract: | IntroductionMaternal and childhood vaccine decision-making begins prenatally. Amongst pregnant Australian women we aimed to ascertain vaccine information received, maternal immunisation uptake and attitudes and concerns regarding childhood vaccination. We also aimed to determine any correlation between a) intentions and concerns regarding childhood vaccination, (b) concerns about pregnancy vaccination, (c) socioeconomic status (SES) and (d) uptake of influenza and pertussis vaccines during pregnancy and routine vaccines during childhood.MethodsWomen attending public antenatal clinics were recruited in three Australian states. Surveys were completed on iPads. Follow-up phone surveys were done three to six months post delivery, and infant vaccination status obtained via the Australian Childhood Immunisation Register (ACIR).ResultsBetween October 2015 and March 2016, 975 (82%) of 1184 mothers consented and 406 (42%) agreed to a follow up survey, post delivery. First-time mothers (445; 49%) had significantly more vaccine concerns in pregnancy and only 73% had made a decision about childhood vaccination compared to 89% of mothers with existing children (p-value < 0.001). 66% of mothers reported receiving enough information during pregnancy on childhood vaccination. In the post delivery survey, 46% and 82% of mothers reported receiving pregnancy influenza and pertussis vaccines respectively. The mother's degree of vaccine hesitancy and two attitudinal factors were correlated with vaccine uptake post delivery. There was no association between reported maternal vaccine uptake or SES and childhood vaccine uptake.ConclusionFirst time mothers are more vaccine hesitant and undecided about childhood vaccination, and only two thirds of all mothers believed they received enough information during pregnancy. New interventions to improve both education and communication on childhood and maternal vaccines, delivered by midwives and obstetricians in the Australian public hospital system, may reduce vaccine hesitancy for all mothers in pregnancy and post delivery, particularly first-time mothers. |
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| Keywords: | Vaccine attitudes behaviours and concerns Pregnancy Vaccine decision-making Maternal vaccination Childhood vaccination Vaccine uptake |
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